Bill seeks to allow medical care at sober living homes

March 14, 2013

Updated Aug. 21, 2013 1:17 p.m.

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Brandon Jacques, 20, a college student from Missouri, might be alive today if not for an unusual California law that prevented him from receiving medical care where he needed it most. NEDA.NATIONALEATINGDISORDERS.ORG

Depending on your perspective, you could argue Brandon Jacques might be alive today if not for an unusual California law that prevented him from receiving medical care where he needed it most.

A college student from Missouri, Jacques died in Orange County two years ago after entering treatment for bulimia and alcoholism at the troubledMorningside Recovery rehab center in Newport Beach, according to a lawsuit filed by the Jacques family. The suits says that Morningside officials knew he was suffering from hypokalemia and other electrolyte imbalances, and promised to keep him safe until he could be moved to a hospital for inpatient treatment of his eating disorder.

But residential detox facilities can't make such promises about clients with very serious health issues. State law ensures that.

You see, unlike many other states, California law specifically prohibits medical care in residential rehab centers. That meant Morningside was legally barred from having medical staff monitor Jacques where he was staying. So was First House, another Orange County rehab clinic where Jacques was transferred. On April 2, 2011, while watching television at a First House facility in Costa Mesa, Jacques went into cardiac arrest and later died at Hoag Hospital. He was 20.

Since then, the state Department of Alcohol and Drug Programs has revoked the licenses of both Morningside and First House, but Assemblyman Allan Mansoor has spent the last year looking for a more system-wide solution. In 2012, the Costa Mesa Republican introduced legislation that would have required more oversight of sober living homes where clients like Jacques stay, but it went nowhere. This year, he's introducing legislation that would eliminate the ban on medical services – a change recommended by an investigator with the state Senate.

"Brandon's death establishes how facilities like Morningside operate in the loopholes of the system and gives authenticity to Assemblyman Allan Mansoor's efforts behind the bill. I really hope it passes," said J. Paul Sizemore, the Jacques family attorney, in an email.

Mansoor describes his bill as "an important proposal to address the quality of care in residential rehabilitation homes. It will enable facilities to provide the appropriate level of care to safely treat individuals who choose to enter rehab while ensuring it is done safely through state licensure."

Morningside CEO Mary Helen Beatificato said she's never understood the medical ban on residential detox facilities and would support a change, although she noted that Morningside now only operates sober living homes and an outpatient clinic. Beatificato declined to discuss the details of Jacques death but said a removal of the medical ban would have had no impact on the Jacques case because Morningside staff has no problem taking clients to other providers for care if they know the clients need it.

The report's author, former Sacramento Bee investigative reporter John Hill, found that eight large states – Illinois, Indiana, New York, North Carolina, Ohio, Pennsylvania, Texas and Washington – allow doctors and other medical personnel to work in residential care settings.

"Several not only allow doctors to oversee detox, but require it," he wrote.

The report, which specifically highlights Jacques' case, recommends that the Legislature approve "a bill allowing medical care in residential facilities." It notes, however, that three bills in the past three years have sought to change the law, but all died in the process.

"That leaves lawmakers, the administration, the industry and its clients facing a situation that many have described as untenable," Hill wrote.

The Senate report suggests that drug rehab clinics are open to the change, but Mansoor will have to navigate a number of unresolved issues if he wants his bill to get approved. Among the issues that could block his legislation is the pending closure of the state Department of Alcohol and Drug Programs and the uncertainty surrounding which agency will pick up its functions after it's eliminated on July 1.

Mansoor intends to introduce his proposal into Assembly Bill 40 in the coming days. The Jacques family suit is still pending. And residential rehab clinics across California continue touting the safety of their facilities.

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